NR 341 Complex Adult Health
Final Exam
Indication for arterial line placement? Correct Ans= Hemodynamic
monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
What test must be preformed prior to an arterial line placement? Correct
Ans= Allen's test
How often should a fast flush test be preformed? Correct Ans= Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? Correct Ans=
Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: Correct Ans= 30-60 degrees of
dorsiflexion with the aid of a roll of gauze and an armband.
Avoid hyperabduction of the thumb.
How often should the atrial line catheter be changed out? Correct Ans=
Every 7 days
Causes of inaccuracy in arterial line readings: Correct Ans= Air bubbles in the
catheter system
Failure to zero the transducer air-fluid interface
Blood in the catheter system
Blood clot at the catheter tip
Kinking of the tubing system
Catheter tip lodging against the arterial wall
Soft, compliant tubing
Long tubing
Too many stopckcks (>3)
,What is the pathology of afterload? Correct Ans= The pressure in which the
heart must pump against in order to eject blood during systole.
Medications that reduce afterload/preload include? Correct Ans= Vasodilators
What is the pathology of preload? Correct Ans= The filling pressure of the
heart at end of diastole.
What is systemic vascular resistance (SVR)? Correct Ans= Resistance the left
ventricle must overcome to open the aortic valve and eject a volume of
blood into systemic circulation.
Systemic vascular resistance (SVR) is used for what calculations? Correct
Ans= Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? Correct Ans= Resistacne the
right ventricle must overcome to open the pulmonic valve and eject a
volume of blood in the pulmonary vasculature.
What is pulmonarartery occlusion pressure (PAOP)? Correct Ans= The
pressure created by the volume of blood that remains in the left heart at
end-diastole.
Inotropic drugs mode of action: Correct Ans= Negative inotropic drugs
weaken the force of muscular contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: Correct Ans= Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: Correct Ans= Relaxes the smooth muscles of
the blood vessels opening them up.
Vasodilator drug examples: Correct Ans= CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
, Lisinopril (Prinivil, Zestril)
Kayexalate Correct Ans= Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate Correct Ans= Prevents and treats cardiac toxicity related
to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)?
Correct Ans= Dialysis
This is a blood filtering therapy that replaced the normal blood-filtering
function of the kidneys in patients with renal failure and acute kidney
injuries.
The prerenal system Correct Ans= Delivers blood to the kidneys.
A prerenal block is: Correct Ans= An interruption on the way to the kidneys.
The intrarenal system Correct Ans= Processes ultra-filtrate by tubular
secretion & re-absorption.
An intrarenal block is: Correct Ans= Direct damage to the kidneys.
The postrenal system Correct Ans= Excretes kidney waste products through
the ureters, bladder, and urethra.
A postrenal block is: Correct Ans= Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): Correct Ans= <400
mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): Correct Ans= Urine
output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): Correct Ans= Cr
>1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
Final Exam
Indication for arterial line placement? Correct Ans= Hemodynamic
monitoring
Multiple blood samples
Diagnostic or interventional radiology procedures
Continuous cardiac output monitoring
What test must be preformed prior to an arterial line placement? Correct
Ans= Allen's test
How often should a fast flush test be preformed? Correct Ans= Every 8 hours
After blood draws
If the hemodynamic status changes
When changing tubing
What are the most common sites for arterial line insertion? Correct Ans=
Radial
Femoral
Axillary
Dorsalis Pedis
Brachial Arteries
Positioning for radial arterial line placement: Correct Ans= 30-60 degrees of
dorsiflexion with the aid of a roll of gauze and an armband.
Avoid hyperabduction of the thumb.
How often should the atrial line catheter be changed out? Correct Ans=
Every 7 days
Causes of inaccuracy in arterial line readings: Correct Ans= Air bubbles in the
catheter system
Failure to zero the transducer air-fluid interface
Blood in the catheter system
Blood clot at the catheter tip
Kinking of the tubing system
Catheter tip lodging against the arterial wall
Soft, compliant tubing
Long tubing
Too many stopckcks (>3)
,What is the pathology of afterload? Correct Ans= The pressure in which the
heart must pump against in order to eject blood during systole.
Medications that reduce afterload/preload include? Correct Ans= Vasodilators
What is the pathology of preload? Correct Ans= The filling pressure of the
heart at end of diastole.
What is systemic vascular resistance (SVR)? Correct Ans= Resistance the left
ventricle must overcome to open the aortic valve and eject a volume of
blood into systemic circulation.
Systemic vascular resistance (SVR) is used for what calculations? Correct
Ans= Blood pressure
Blood flow
Cardiac function
What is pulmonary vascular resistance (PVR)? Correct Ans= Resistacne the
right ventricle must overcome to open the pulmonic valve and eject a
volume of blood in the pulmonary vasculature.
What is pulmonarartery occlusion pressure (PAOP)? Correct Ans= The
pressure created by the volume of blood that remains in the left heart at
end-diastole.
Inotropic drugs mode of action: Correct Ans= Negative inotropic drugs
weaken the force of muscular contractions.
Positive inotropic drugs increase the strength of muscular contractions.
Inotropic drug examples: Correct Ans= Dobutamine
Digoxin
Milrinone
Dopamine
Vasodilator mode of actions: Correct Ans= Relaxes the smooth muscles of
the blood vessels opening them up.
Vasodilator drug examples: Correct Ans= CCBS:
Verapamil (Calan, Isoptin)
Diltiazem (Cardizem)
Atorvastatin (Lipitor)
Nitrates:
Sildenafil (Viagra)
Nitroprusside (Nipride, Nitropress)
ACE:
Captopril (Capoten)
, Lisinopril (Prinivil, Zestril)
Kayexalate Correct Ans= Exchanges K+ ions for Na+
Excess K+ ions are fecally excreted
Calcium Gluconate Correct Ans= Prevents and treats cardiac toxicity related
to increased K+ levels
What is the purpose of Continuous Renal Replacement Therapy (CRRT)?
Correct Ans= Dialysis
This is a blood filtering therapy that replaced the normal blood-filtering
function of the kidneys in patients with renal failure and acute kidney
injuries.
The prerenal system Correct Ans= Delivers blood to the kidneys.
A prerenal block is: Correct Ans= An interruption on the way to the kidneys.
The intrarenal system Correct Ans= Processes ultra-filtrate by tubular
secretion & re-absorption.
An intrarenal block is: Correct Ans= Direct damage to the kidneys.
The postrenal system Correct Ans= Excretes kidney waste products through
the ureters, bladder, and urethra.
A postrenal block is: Correct Ans= Obstruction of urine output.
Causes:
Enlarged prostate
Kidney stones
Bladder tumor
Bladder injury
S/SX of the oliguric phase of acute kidney injury (AKI): Correct Ans= <400
mL/24hr
Increase BUN, Cr, uric acid, K, Mg
Metabolic Acidosis
S/SX of the diuretic phase of acute kidney injury (AKI): Correct Ans= Urine
output 1-3L/day
Decreased K & Na
S/SX of the risk stage of acute kidney injury (AKI): Correct Ans= Cr
>1.5xbaseline
Urine output <0.5ml/kg/hr for 6+ hours
